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Incidence of Infectious Gastroenteritis
by Family Size, Cleveland,
Ohio, 1964
Family	Person	Family	of Family	Illnesses per	Illnesses per
Size	Days	Days	Illnesses	Family/Year	Person/ Year
3	38,991	12,997	104	2.92	0.97
4	269,604	67,401	869	4.71	1.18
5	399,450	79,890	1,671	7.63	1.53
6	201,396	33,566	1,044	11.35	1.89
7	36,491	5,213	189	13.23	1.89
8	31,104	3,888	180	16.90	2.11
Source: Dingle et al. (7).
increases. Leaving aside a consideration of the precise causal role of family size per se in producing illness, it is obvious that family size increases "pressure" on the larger families simply because of the number of illnesses, more need for maternal care, more expenses for treatment.
One of the most important kinds of morbidity to be found in preschool children throughout the world is that produced by malnutrition (8, 9). In a study of malnutrition in the preschool child population of the rural town of Candelaria, Colombia, my former colleague, Dr. Alfredo Aguirre, and I found that family size is one of the factors involved in the etiology of malnutrition there (10). In a house-to-house survey of the town, the total population of preschool children were weighed and measured and their mothers interviewed. The nutritional status of the children was determined on the basis of internationally recommended standards (11-14). We found 1,094 children under 6 years of age in the survey; 284 of these children were classified as having first degree, 148 second degree, and 14 third degree malnutrition—a total of 41 percent malnourished in varying degrees.
We then examined the data for associations between various social and demographic factors in the families and malnutrition in the children. The effects of family size were explored by grouping all of the children according to the number of living children in their families. The proportion of malnourished children (of all degrees) in each group was then calculated. The results of this analysis are shown in Table 2, where the trend is obvious: children from larger families are more likely to be malnourished than those from smaller families.* In this case, the difference in the prevalence of malnutrition
*Some of the other factors, both social and economic, that were implicated in the cause of malnutrition will be described in the next-to-last section of this chapter. It should be mentioned here that we found in the Candelaria study that as laboring men in of various common illnesses by family size. As an example, their findings with